MAPD - after employer coverage

[gregj]

If a person is working for a large employer, the wiser choice is often to delay Part B enrollment.

depends on the employer, but arguably increasingly less & less wise, on the economics and/or coverage

 

[sshafran]

I see it now

View attachment 4734

View attachment 4735


Still need clarification on the following, because the second image is what confused me,

It's ICEP... it says "creditable coverage" but it also says having Part A and delayed Part B... i assumed employer coverage as the creditable coverage, which it is... which is why I didn't understand

When you delay to keep employer coverage, are you delaying both Part A and B or just A?

I know you can just have Part A and delay Part B. Why would someone do this if not for employer coverage?

Like many situations, this person has 2 election periods - but the SEP is a little more "flexible" for them.

Example: John enrolled in Part A @ 65 3 yrs ago. Now retiring at age 68. John has enrolled in Part B, effective 11/01/18, because he will retire on 10/15 and his group coverage will end at the end of the month (Oct).

True, ICEP is available. If you get the application in by 10/31 (deadline), you can use ICEP, effective 11/01/18. The deadline is 10/31 b/c Part B starts 11/01.

John has a lot on his mind... retiring, etc., and isn't quite sure what plan to take, after all, when he turned 65 he got TONS of mail, but isn't getting quite as much now and is, frankly, putting things off until after his vacation at the end of October celebrating his retirement.

So, he's in your office the 2nd week of November...

You can't use ICEP now. Too late. Use SEP - loss of EGHP.

Does that help?

You should have a comprehensive Election Period Booklet. I'll attach the one I use here in a minute...

 

[sshafran]

This is the guide I use most often - it's pretty helpful.

 

[sshafran]

If you don't use SEP LEGHP then the person will likely have a LEP for Part D so SOOL

That's interesting. I've (personally) always used SEP LEGHP on the app, and have not used ICEP, even when it would have been "valid."

I did not know that using the ICEP would trigger LEP... interesting.

 

[sshafran]

When you delay to keep employer coverage, are you delaying both Part A and B or just A?

I know you can just have Part A and delay Part B. Why would someone do this if not for employer coverage?

1st question - no, people enroll in A, delay B.

Why would some delay Part B if not covered by employer? Have you ever run into any cheapskates in your life - i.e., those who will drive 4 miles out of the way to save $.02 on gas? Or those who drink the cheapest coffee available even though it tastes horrible?

Well, they see "$134 for Medicare!!! I worked my whole life, I'm not paying for Part B if I don't have to - I'll be just fine...." So, they delay - they aren't the brightest crayons in the box.

(occasionally there are legitimate, "I didn't know" reasons, but for the most part, it's someone trying to pinch pennies)

 

[sshafran]

depends on the employer, but arguably increasingly less & less wise, on the economics and/or coverage

LD is in the trenches every day talking to people about their employer coverage vs. medicare options, are you sure you want to disagree with him?

(granted, he did "hedge" his statement by not being dogmatic... but you're right, the EGHP's are becoming less attractive every year vs. Medicare + Supplement + PDP. I only see people coming off the employer plan maybe 15% of the time...)

 

[LostDollar]

depends on the employer, but arguably increasingly less & less wise, on the economics and/or coverage

I did say often rather than absolutely. This is a situation which I have personally lived, on both counts.

 

[gregj]

This is a situation which I have personally lived, on both counts.

not sure either what this means or how it might be dispositive

 

[JJ2713]

Like many situations, this person has 2 election periods - but the SEP is a little more "flexible" for them.

Example: John enrolled in Part A @ 65 3 yrs ago. Now retiring at age 68. John has enrolled in Part B, effective 11/01/18, because he will retire on 10/15 and his group coverage will end at the end of the month (Oct).

True, ICEP is available. If you get the application in by 10/31 (deadline), you can use ICEP, effective 11/01/18. The deadline is 10/31 b/c Part B starts 11/01.

John has a lot on his mind... retiring, etc., and isn't quite sure what plan to take, after all, when he turned 65 he got TONS of mail, but isn't getting quite as much now and is, frankly, putting things off until after his vacation at the end of October celebrating his retirement.

So, he's in your office the 2nd week of November...

You can't use ICEP now. Too late. Use SEP - loss of EGHP.

Does that help?

You should have a comprehensive Election Period Booklet. I'll attach the one I use here in a minute...

Yes, I understand better now.

So, I was correct in my initial post about the ICEP. I didn't realize the person also has a second period, the SEP they could use as well to give them more time.

 

[JJ2713]

If you don't use SEP LEGHP then the person will likely have a LEP for Part D so SOOL

Why is that?

Why is there a part D penalty for someone coming off employer coverage if they use ICEP instead of SEP EGHP?

Is it because ICEP #2 is for people who have Part A but delay Part B? And you need either A or B for a Part D plan? So the person had A but all the time went by during employer coverage was basically penalty time? Because as soon as the qualification is met (either A or B, or A & B), then the clock starts? But the employer coverage should be creditable.

What if the person also delayed A... didn't have A or B? Then they couldn't use the ICEP #2 anyway since they don't have A... think I'm answering my own question.